About the procedure, goals and recommendations
Periodontal accelerated osteogenic orthodontics, or surgically assisted orthodontic treatment is a minimally invasive procedure performed on the adult patient. This method has become popular over the past 10 years due to the significant reduction of the time period necessary for completing an orthodontic treatment.
The principle upholding the orthodontic movement is bone remodelling through resorption / construction, and the methods of speeding up the orthodontic movements focus around this remodelling process. They derive from an inflammatory process initiated and controlled by cytokines, which stimulate osteoclast activity.
These inflammatory markers have a short lifespan, which explains the search for methods of increasing the cytokines level, among which the inducing of a micro-trauma to the bone and the periodontal ligaments. The inflammatory process generates a state of transitory osteopenia, while the low density of the bone facilitates the rapid movement of the teeth.
Ideal candidates
Most likely to benefit from this method are adult patients with high aesthetic expectations, reluctant to undergo an orthodontic treatment that would last approximately 2 years.
This procedure addresses patients with:
- moderate to severe dental crowding in Class 1
- moderate to medium crowding in Angle Class 2 or 3
- patients who require unilateral expansions
- intrusions, extrusions or other rapid dental displacements, with the aim of creating the spaces necessary for performing dental works or inserting implants.
Precautions. Contraindications
The surgically assisted orthodontic treatment is not recommended for patients with the following problems:
- untreated chronic marginal periodontitis
- thin cortical bone tissue;
- severe inverse occlusions
- general conditions that do not allow surgical procedures.
The intervention
The surgical intervention consists in fastening on the teeth an orthodontic device, which is activated for the first time at 10-14 days after the procedure, and subsequently with a two weeks rhythmicity (in the cases where Invisalign is used, the device is modified every 5 days). The treatment can be applied over a period of 4-6 months. During this time occur most of the vertical, sagittal and transverse movements, due to the increased speed in teeth displacement.
This method includes:
- a surgical stage consisting in creating ditches / perforations on the level of the cortical bone structure, followed by a bone graft augmentation (the surgical procedure is performed under local anesthesia)
- an orthodontic stage per se
The result of the intervention
The PAOO method has numerous advantages, which easily convince the adult patient of its necessity. Among these, we mention:
- a duration of the orthodontic treatment 3 to 4 times shorter than in the case of the classical treatment
- a decreased risk of recurrence, rapid repositioning of impacted canines
- the treatment of malocclusion cases without the need for orthognathic surgery
- the elimination of the necessity for dental extractions (in some cases)
- the elimination of the risk of radicular resorptions and of the occurence of periodontal defects
- reduction of the costs entailed by a prolonged orthodontic or a combined ortho-surgical treatment
Thus, the patient will enjoy a beautiful smile in a much shorter time, the result being both aesthetic and functional.